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The clinical use of Frational Flow Reserve （ FFR ） is limited by the adverse effects of adenosine or other microvascular dialators. Other physiological lesion assessment procedures independent with adenosine are under consideration. The clinical feasibility of contrast induced fractional flow reserve (cFFR), which is considered one the most promising non-adenosine procedures, is assessed in this study.
70 patients were involved in this retrospective analysis, with the average age at 60.7±9.6 years old. FFR and cFFR were performed simultaneously 117 times in 87 vessels. Physiological significance of FFR was defined as <0.80. The correlation and the diagnostic consistency between FFR and cFFR, as well as the affecting factors, were analysised.
The value of FFR and cFFR were 0.80(0.74, 0.87) and 0.86(0.80,0.90) seperately. Significant relationship was observed between two functions (r=0.92, P<0.0001). Take ≤0.80 as the cut-off value derived by FFR, the propriate cut-off value of cFFR should be ≤0.83, with a diagnostic consistency of 84.6%. When taking the sensitivity and specifity as over 95%, the gray zone of cFFR was 0.83 ～ 0.86. The diagnostic consistency could be increased to 90.6% when these grey-zone patients were re-analyzed by FFR, mean while, the FFR usage were reduced by 80.3%.
There is a significant linear correlation between cFFR and FFR, which indicating cFFR as a good substitute for FFR. The cFFR and FFR hybridization strategies reduce the use of adenosine by around 80% when the diagnostic consensus rate is guaranteed to reach 90%.
IMAGING: FFR and Physiologic Lesion Assessment